BETHANEY CLARK (NPI# 1427517234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427517234 |
| Entity Type | Individual |
| Full Name | BETHANEY CLARK |
| Practice Address |
123 E Powell Blvd Ste 303 Gresham OR 97030-7620 |
| Mailing Address |
4233 Se 182nd Ave # 212 Gresham OR 97030-5082 |
| Practice Telephone | 9712201495 |
| Mailing Telephone | 9712201495 |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
123 E POWELL BLVD STE 303 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-7620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417197898 | Michelle Christine Simmons | Counselor | 123 E Powell Blvd Ste 303, Gresham, OR 97030-7620 | 2009-02-25 |
| 1457846008 | Angela M. Caiazza, PC | Marriage & Family Therapist | 123 E Powell Blvd Ste 303, Gresham, OR 97030-7620 | 2018-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215403449 | Catherine Jones Counseling LLC | Counselor | 320 N Main Ave Ste 201c, Gresham, OR 97030-7242 | 2018-10-15 |
| 1710423058 | Marcella Lee | Counselor | 1294 Nw Wonderview Dr, Gresham, OR 97030-4995 | 2017-01-10 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1346610680 | Juliet Chandler | Counselor | 24050 Se Stark St Apt 502, Gresham, OR 97030-3167 | 2015-09-29 |
| 1841540788 | Justin Hull | Counselor | 818 Ne Division St, Gresham, OR 97030-3951 | 2012-09-19 |
| 1962655407 | Erik Michael Rasmusson | Counselor | 912 Ne Kelly Ave, Gresham, OR 97030 | 2008-10-28 |
| 1053939207 | Kelsey Nolan | Counselor | 2222 E Powell Blvd, Gresham, OR 97080-1365 | 2020-07-13 |
| 1235798372 | Timothy Hadden | Counselor | 400 Ne 7th St, Gresham, OR 97030-5604 | 2019-06-12 |
| 1649737115 | Kayla Dawn Smith | Counselor | 2222 E Powell Blvd, Gresham, OR 97080-1365 | 2019-02-21 |
| 1356810493 | Simona Vazquez-sartori | Counselor | 400 Ne 7th St, Gresham, OR 97030-5604 | 2018-11-19 |
| Find all providers in GRESHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.